Provider Demographics
NPI:1891140935
Name:JENKINS, JAMES TRAVIS (DO)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:TRAVIS
Last Name:JENKINS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 MCCULLOUGH AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-4814
Mailing Address - Country:US
Mailing Address - Phone:210-271-3204
Mailing Address - Fax:210-222-2761
Practice Address - Street 1:1100 MCCULLOUGH AVE STE 300
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-4814
Practice Address - Country:US
Practice Address - Phone:210-271-3204
Practice Address - Fax:210-222-2761
Is Sole Proprietor?:No
Enumeration Date:2016-04-26
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS1829207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX398614301Medicaid